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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
Safe Sleep

Introduction

This toolkit summarizes content from the Safe Sleep Evidence Accelerator and the MCHbest database. The peer-reviewed literature supporting this work can be found in the Established Evidence database. Use the resources below as you develop effective evidence-based/informed programs and measures.

From the MCH Block Grant Guidance. Sleep-related infant deaths, also called Sudden Unexpected Infant Deaths (SUID), account for the largest share of infant deaths after the first month of life.1 SUID includes Sudden Infant Death Syndrome (SIDS), ill- defined deaths, and accidental suffocation and strangulation in bed.

Due to heightened risk of SIDS when infants are placed to sleep in side (lateral) or stomach (prone) sleep positions, the American Academy of Pediatrics (AAP) has long recommended the back (supine) sleep position.

To further reduce SUID, the AAP has several other recommendations for a safe sleep environment that include using a firm non-inclined sleep surface (e.g., crib or bassinet), room-sharing without bed-sharing, and avoiding soft bedding and overheating.2

Goal. To increase the percent of infants placed to sleep on their backs and in a safe sleep environment.

Note. Access other related measures in this Population Domain through the Toolkits page.

Detail Sheet: Start with the MCH Block Grant Guidance

DEFINITION

Numerators:

A) Number of women who reported that they placed their infant to sleep only on their backs (not stomach or side) in the past two weeks
B) Number of women who reported that their infant always slept alone in their own crib or bed while they themselves were sleeping in the past two weeks. Cribs or beds include a crib, portable crib, or bassinet, and not a twin or larger mattress or bed, couch, sofa, armchair, car seat, swing, rocker, or other inclined sleeper.
C) Number of women who reported that their infant was not placed to sleep with comforters, quilts, blankets, non-fitted sheets, soft toys, cushions, pillows (including nursing pillows), or crib bumper pads (mesh or non-mesh) in the past two weeks
D) Number of women who reported that their infant’s crib or bed was in the same room where they or another adult slept in the past two weeks

Denominators:

A-D) Number of women with a recent live birth, excluding those whose infant has died or is not currently living with them

Units: 100

Text: Percent

HEALTHY PEOPLE 2030 OBJECTIVE

Related to Maternal, Infant, and Child Health (MICH) Objective 14: Increase the proportion of infants placed to sleep on their backs (Baseline: 78.7% of infants born in 2016; Target: 88.9%); Related to MICH Objective D3: Increase the proportion of infants who are put to sleep in a safe sleep environment. (Developmental)

DATA SOURCES

Pregnancy Risk Assessment Monitoring System (PRAMS)

MCH POPULATION DOMAIN

Perinatal/Infant Health

MEASURE DOMAIN

Health Behavior

1. Accelerate with Evidence—Start with the Science

The first step to accelerate effective, evidence-based/informed programs is ensuring that the strategies we implement are meaningful and have high potential to affect desired change. Read more about using evidence-based/informed programs and then use this section to find strategies that you can adopt or adapt for your needs.

Evidence-based/Informed Strategies: MCHbest Database

The following strategies have emerged from studies in the scientific literature as being effective in advancing the measure. Use the links below to read more about each strategy or access the MCHbest database to find additional strategies.

Chart of Evidence-Linked Strategies and Tools

Evidence-Informed

Evidence-Based

Mixed Evidence

Emerging Evidence

Expert Opinion

Moderate Evidence

Scientifically Rigorous
 

 

Field-Based Strategies: Find promising programs from AMCHP’s Innovation Hub

Cutting Edge:

Emerging:

Promising:

Best:

2. Think Upstream with Planning Tools—Lead with the Need

The second step in developing effective, evidence-based/informed programs challenges us to plan upstream to ensure that our work addresses issues early and is measurable in “turning the curve” on big issues that face MCH populations. Read more about moving from root causes to responsive programs and then use this section to align your work with the data and needs of your populations.

Move from Need to Strategy

Use Root-Cause Analysis (RCA) and Results-Based Accountability (RBA) tools to build upon the science to determine how to address needs.

Planning Tools: Use these tools to move from data to action

3. Work Together with Implementation Tools—Move from Planning to Practice

The third step in developing effective, evidence-based/informed programs calls us to work together to ensure that programs are implementable and moveable within the realities of Title V programs and lead to improved health outcomes for all people. Read more about implementation tools designed for MCH population change and then use this section to develop responsive strategies to bring about change that is responsive to the needs of your populations.

Additional MCH Evidence Center Resources: Access supplemental materials from the literature

Implementation Resources: Use these field-generated resources to affect change

Practice. The following tools can be used to translate evidence to action to advance this NPM:

Partnership. The following organizations focus efforts on supporting infant safe sleep:

References

Introductory References: From the MCH Block Grant Guidance

1 Moon RY, Carlin RF, Hand I; Task Force on Sudden Infant Death Syndrome and the Committee on Fetus And Newborn. Evidence Base for 2022 Updated Recommendations for a Safe Infant Sleeping Environment to Reduce the Risk of Sleep-Related Infant Deaths. Pediatrics. 2022;150(1):e2022057991.

2 Moon RY, Carlin RF, Hand I; Task Force on Sudden Infant Death Syndrome and the Committee on Fetus And Newborn. Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment. Pediatrics. 2022;150(1):e2022057990. doi:10.1542/peds.2022-057990. https://publications.aap.org/pediatrics/article/150/1/e2022057991/188305/Evidence-Base-for-2022-Updated- Recommendations-for

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.